STABBED

I've been putting this off long enough. I just need to get it out. Here's the last installment of the story of how our IVF cycle turned into a nightmare. If you missed the beginning of this story, you'll want to read this post first, then read this one.

Deep breath. I can do this.

Once admitted to my hospital room, I had a team of nurses buzzing frantically around my room. Though they worked quickly and seriously, they did a nice job of keeping everyone thinking that this problem was, in fact, fixable. It was now after 5:00 AM and I had been violently ill for over two hours. The nausea and vomiting was getting worse; I gasped for air between painful retches. As I continued to be sick into my trusty hospital-issued mauve bucket, Kev stayed by my side, dabbing my face with a cool rag. Meanwhile, Nurse #1 attempted for fifteen minutes to find a vein in my left arm for an IV. She stuck me several times, but found no usable vein and no blood - I was too dehydrated. Nurse #2 took over and began sticking my other arm. She tried for another fifteen minutes and was about to give up when she finally was able to find a vein on the back side of my forearm near my elbow. As soon as the IV fluid hit my bloodstream, I suddenly felt life again coursing into my fingers. I hadn't realized until that moment how dead I had felt. Although I was still vomiting, I raised my hand to my face, in an attempt to see color return. I couldn't see anything but the bottom of that ugly mauve bucket.

I was given the first of six shots of Hep.arin in my stomach and a shot of nausea medication in my IV. In addition, I was given an initial round of nine bottles of Alb.umin in my IV. Over the next two days, I would be given somewhere around 20 bottles of this medication (I lost count). I was very hopeful that the vomiting would immediately stop as the nurses had promised, but I was so far gone that the vomiting lasted another eight hours for a total of eleven grueling hours of the most extreme nausea I didn't know existed. Once the vomiting finally stopped around 2:00 PM, I felt I had returned from the dead.

My fertility specialist came to my room around 3:00 and told me how much better I looked. I don't remember seeing him prior to this; apparently, I had my head in the mauve bucket the first time he came to check on me. He ordered that my abdomen be tapped to drain the excess fluid that had built up over the previous four days.

Oh God, give me strength. This is where it gets ugly. The squeamish may want to skip the next paragraph.

I was wheeled down to the radiology department where the nurse sonogramed my abdomen to find the best place to make the incision. He X'ed me with a magic marker and left me there for over an hour as I waited for the doctor to perform the procedure. The doctor finally showed up and shot the local anesthetic into my abdomen. It stung a little at first, but I gritted my teeth and the pain quickly subsided as the anesthetic began to work. Then it was time to make the incision. He began cutting. At first, I only felt pressure. But as his scalpel reached beyond the superficial layer of my abdomen, I felt the blade of the scalpel stabbing, cutting, tearing deeper and deeper. I screamed in pain. I screamed and screamed and begged him to stop. I screamed and stretched and waved my arms out in an attempt to find something to hold on to. There was nothing there to hold. There was no one there to help me. He screamed for the nurse to turn on the light. I screamed for a break so I could catch my breath. I don't know what he did with the light, but he soon asked for it to be turned out again so he could watch the sonogram and finish the incision. And so he did. And so I continued crying and screaming as the scalpel stabbed deeper and deeper. Several minutes later, he was finally through. He inserted the drainage tube and attached the collection bag to my leg. As I lie there trying to stop crying and to catch my breath, the nurse brought me a form and a pen and told me to sign. I was shaking so hard and had tears clouding my vision, so I asked him what it was he needed me to sign. He did not tell me. He just repeated that I needed to sign it. I asked again and got the same response. All I wanted to do was get the hell out of there and away from the man who just stabbed me. I signed it. The nurse helped me into a wheelchair and took me back up to my room. When my mother-in-law saw me white as a ghost and shaking, she went limp, obviously worried, and asked me what had happened. I couldn't speak. All I could do was shake my head and quiver.

I don't know what went wrong. I don't know why I could feel the scalpel slicing my flesh open. The doctor who performed the procedure came up to my hospital room and gave some lame excuse that his needle wasn't long enough to reach all the layers of my abdomen. I know that has to be bullshit. I'm not that big. He fucked up and was trying to cover his ass. I will be filing a formal complaint with the hospital. I don't want anyone else to have to endure that terrifying pain. Imagine a small child in that man's poor care. He needs his cutting license removed. I'd like to cut him. I digress.

Over the next 30 hours, over two gallons of fluid was removed from my abdomen. As disgusting as that sounds, it was definitely sweet relief to no longer have that fluid crushing my organs. I was given more Hep.arin, several shots of Dem.erol, and loads of Darv.ocet. Neither of the pain medications did anything to alleviate the torture of the drainage tube lodging itself into my enlarged and extremely tender ovaries. Once the tube was removed, I was pain-free for the first time in five long days.

I was sent home Wednesday evening around 9:00. I had an appointment for embryo transfer the next morning. At the appointment, I told my doctor that I had been extremely dizzy since 4:00 PM the previous night and that I still was not urinating. The embryo transfer was cancelled. I was still too sick with OHSS too transfer. He said it would have been inevitable that I would have ended up in the hospital again if the embryos implanted. The OHSS would be worse and would last much longer. Weeks or months. I was crushed.

Writing this post has been difficult. I had to stop and cry a couple of times, but I think it has helped me. Maybe now that I've gotten it out, the insomnia and nightmares will stop.

Now on to our frozen embryo transfer in August. We have ten embryos frozen and waiting for us. I can't wait to meet them. I love them already.

SHOW & TELL - BROKEN UP

Is it possible to Show and Tell about two completely different things? I'll try. Let's see how it works out.

First, the show:

Our new puppy Polly. She's about ten days old and I can't wait for her to come home.

Next, the tell:
I'd like to continue the story of my recent hospitalization, but honestly, I'm getting to the traumatic part that I keep reliving over and over and I don't think I'm quite ready to write about it. If you missed the beginning of the story, read this first, then read this one. You'll have to check back soon to get the most intense part of the story. I promise I'll write about it. I just need a minute to catch my breath.

MISERY

If you missed the beginning of this story, read this first.

To follow up on the story from yesterday...

After the egg-retrieval I spent two hours in the recovery room because my nurse's computer crashed. This made me VERY uncomfortable and unhappy. I just wanted to see my husband and get the report from the retrieval and go home. They finally released me, escorting me in a wheelchair to my car. And so the super fun-time OHSS party begins.

I began feeling very ill in the car. We only had a fifteen minute drive from the hospital to our house, but somewhere on the highway, I informed Kev that I was going to faint. And so I did. As he maneuvered the highway, he held my unconscious head in his hand, in an attempt to keep me sitting upright even though I had gone completely limp and fallen between the two front seats of our little SUV. As he later recalled the story to my sister, he said that people probably thought he was some kind of creep riding around I-35 holding on to a cadaver. I regained consciousness at some point, but don't remember the rest of the ride or our arrival at home. Somehow, Kev got me into my PJ's and brought me downstairs to lay on the couch - my new home for the next four days.

If I remember correctly, my sister and sister-in-law came to visit later that afternoon. I was already incredibly bloated by the evening, and walking from the couch to the bathroom was excruciating. As I walked, I was a slow, hunched-over, crying mess of a woman. The Darvocet prescription I was given did nothing to alleviate the pain. I was not in pain from the procedure - I was in pain because the excess fluid on my abdomen was crushing my organs.

Maybe now would be a good time to explain Ovarian Hyperstimulation Syndrome for those of you who are fortunate enough to not have experience with it. OHSS may occur during or after a controlled ovarian stimulation for an IUI or IVF cycle. I have experienced OHSS twice - once during an IUI cycle which we were forced to cancel, and this time, which also caused us to cancel the fresh embryo transfer and postpone two months for a frozen embryo transfer. Symptoms can vary from mild to severe. Mild symptoms cause discomfort, while severe require hospitalization and have, in rare cases, caused death. Symptoms include collection of fluid in the abdominal cavity which causes bloating, shortness of breath, organ pain, possible organ failure, ovarian torsion, decreased urine, dehydration, dizziness, fainting, and vomiting. Here's a good article on the subject written by a woman who has experienced OHSS.

By Friday evening, I was bloated, dizzy, fainting, short of breath, had very little urine which was tea-colored, and in moderate pain. Saturday, my symptoms worsened and I was in so much pain from severe bloating that I could barely breathe, while movement was excruciating. I fainted every time I tried to walk somewhere. That evening, my symptoms were worrying me and I decided to phone the doctor on call. I described my symptoms and she said that as long as I was still urinating and not vomiting I would be okay. She told me to stay on the couch and only move to the bathroom with assistance. She called in another prescription for Darvocet and some nausea medication. Sunday, the pain subsided a bit and only hurt when I moved, as opposed to constant pain, even when at rest. I did, however, faint about six times.

Urination was painful and infrequent, but because I was urinating a little bit, I didn't think I was dehydrated. I was wrong. Very wrong. I wish someone would have described the symptoms better to either me or my husband. I would have gotten help by Saturday when I really needed it. Perhaps the hospitalization could have been avoided.

Monday morning, I woke up and took two bites of an English muffin with jelly and promptly vomited - violently. I took some nausea medication and slept for a few hours. When I awoke, I called the fertility clinic and told them about my morning, but also told them that I was feeling better. Once again, I was told that I would be okay. My embryo transfer was scheduled for Wednesday.

Kev brought me a delicious portabello sandwich for lunch at about 1:00. I was starving. I ate the whole thing. I took more nausea medication and went to sleep. Four hours later, I woke up and began vomiting violently. This time, it didn't stop. Thirty minutes into this frightening episode, I reached for the cordless phone and managed to dial Kev's office. Between retches, I begged him to come home and help me. He promptly left, but got stuck in traffic. Wonderful. When he finally got home, he called the doctor on call and she said that if the nausea subsided then I would need to take more of the nausea medicine. She said that I even needed to be woken up during the night to take it. She scheduled a visit to the clinic for the next morning, so Kev called my parents and asked them to come in to town to take me to my appointment since he had to work.

I woke up to vomit at 3:00 AM. I didn't stop. Kevin woke up at about 4:00 and asked me what the hell I was doing in the corner of the dark basement with my head in a trashcan. I told him I didn't want to wake anyone up, but that I had now been vomiting for over an hour. He called the doctor on call again and told her that I needed to go to the emergency room. Escorted by my mother and father, I carried my giant white trashcan to the car as I continued to vomit violently. I have never experienced such extreme nausea and pain. I wondered if it would ever end.

We got to the hospital at around 4:45. Thanks to the doctor on call, I was able to bypass emergency and be directly admitted - still puking into a mauve-colored plastic bucket - to the last room in the entire hospital. It was a double room, and my poor roommate had to listen to me vomit for hours. That's not to mention the poor man with whom I shared an elevator. I can only imagine what he must have been thinking when he heard my wailing and retching. At one point, I actually cried out to God to help me.

There's more. Lots more. I'll finish up this story tomorrow. Stay tuned.

DANCE FOR ME

I guess I should at least start to record my awesome fun-time carnival of IVF with ICSI.... Wait a minute. I mean egg retrieval and severe OHSS. So...

Kev and I awoke bright and early to go to the hospital for egg retrieval on Friday. We had a very short wait - in fact, they called me in even before I sat down in the waiting room. I went potty like a good girl, then changed into the lovely blue open-back dress and was escorted to the staging area for surgery. I signed papers stating that I understood that I could die under the anesthesia, blah blah blah. They stuck me for the IV and blood shot all over the nurse, onto the floor, and covered my hand. I didn't see this as a good sign. I'm never nervous before a surgery, but I was now nervous for this one. Kev was allowed to come in, and he kept me entertained by spelling words on a calculator. "Boobs," "boobless," "shells." Then he kissed me goodbye.

The nurses came to get me and told me that they would first give me something in my IV to relax. They said it has an amnesiac effect, so that I wouldn't remember anything afterwards. They assured me it was "the best margarita you'll never drink." The male nurse by my head squirted half of a syringeful of this magic cocktail into my IV. I shot the guy an inquisitive and worried look, and he assured me that he would give me the other half of the cocktail once we reached the surgery room.

He didn't lie.

Once we were in there, I was definitely feeling the effects of that "margarita." Feeling no inhibitions, I informed everyone in surgery that the room was pretty boring with all those lights and instruments, so I suggested that they dance for me to liven things up a bit. That's the last thing I remember....

...Until I woke up and asked them if they danced while I slept. The very last thing I remember from that room is hearing the anesthesiologist say, "Holy shit. She remembers!"

The best (er, worst) part is yet to come.

NO TRANSFER

No transfer. I'm still at an elevated risk for OHSS and another hospitalization. Instead, we are freezing the embryos and will transfer in two months, when I am recovered. I've been totally bummed the past few days. I may not update for a while.

A WHIRLWIND

I am way behind on ICLW because I just returned from the hospital last night around 8pm. I was admitted at 4am Monday via the emergency room for severe Ovarian Hyperstimulation Syndrome (OHSS). I will explain it in every gory detail at a later date - I'm still groggy and exhausted from my little adventure right now, so the details will have to wait.

Update on embryo transfer: I will call the clinic today with a report of my progress and health overnight and we will determine from that conversation if I am well enough to handle the transfer today. It is very likely that my symptoms will quickly return upon transfer, so this is a very delicate situation. If we do transfer today, we will transfer two embies and I'm pretty sure we will have plenty to freeze for future cycles! I'm so excited!

1dper

Thank you for all the well wishes. The ER went smoothly. The doc retrieved 20 eggs. Did ICSI with ten and all ten made it through the first night, and the other ten were left to do the magic on their own. Four of those fertilized and one split, so we have fifteen total today! I am hoping for another good report tomorrow.

I have severe bloating, pain, dizziness, and difficulty breathing. I am pretty sure I have OHSS to some degree, but the clinic is not open until Monday. I've just been resting since I got home yesterday, and that's what I am going to have to go do now. The dizziness has caught up to me once again. I don't want to faint again.

Until tomorrow.

Edited to add: I misunderstood. We have 16!!!

SHOW & TELL - TOMORROW

Those are my plans for tomorrow. Wish me luck.

See what the other kids are showing off this week.

BREAKFAST FOR MY BRO

Frozen banana pineapple cups



Southwest soy-sausage and egg casserole



Breakfast upside-down cake

BLOGOVERSARY

The one-year anniversary of this blog came and went in May without even a peep.

I started this blog last year when we were beginning the first of three failed IUI cycles. I was very excited about the prospect of this blog quickly transforming into a chronicle of pregnancy, then of baby's first few years. Quite obviously, that did not happen. Looking back, I now see how naive I was about the success of IUI. I thought it was our magic answer. After all, we'd been trying for several years. We were DUE, right?

Actually, I've been naive about this whole process - about all the treatments. With every new procedure or plan, I find myself calculating due dates and sneaking peeks at baby furniture catalogues. This time has been no different. Kev and I have already decided that we have a pretty good chance of having a baby (or two) on his birthday next year. And last night, I fell asleep envisioning what additions I'd make to the nursery if we were somehow fortunate enough to be blessed with twins.

The word "naive" has such negative connotations. I think I need more positive language in my life right now. Maybe what I've got is not naiveté, but hope. Yes. Hope. That sounds better. But then again, hope can be dangerous, as I've found. If things don't go as I had planned, despair moves in where hope once resided. This is one thing I fear. That crushing despair can be so dark and lonely and consuming and convincing. It's this fear that has kept me from allowing myself to get as excited as I would truly like to be about our upcoming IVF. I am hopeful, of course. It's just a guarded hope.

So with that same guarded hope, I'll continue to trace my journey on this road to baby. I will continue to blog about it with the hope that I will soon be able to transition into a pregnancy blog then a bouncy baby blog.

And I hope to see good follies at my scan tomorrow too.

GIVE ME A GROWN-UP ANSWER, PLEASE

Kev and I decided to find a new clinic to do our IVF. When we interviewed the clinic, we met with a certain IVF coordinator - let's call her B. She was very professional and knowledgeable. She asked all the right questions and answered ours very much to my satisfaction. Having been working with a Reproductive Endocrinologist for three years, Kev and I are pretty up on the infertility lingo of reproductive mechanisms. B did not treat us like idiots. She didn't assume (as medical professionals sometimes do) that Kev and I don't have an intimate knowledge of the workings of the female anatomy - however broken mine is - and she spoke to us in just enough medical and lay terms so as not to offend or alienate us. We left feeling confident that B would do a superb job coordinating our IVF. Honestly, B had a large influence on our deciding to use that clinic (as opposed to the other clinic who didn't even know what questions to ask me - I ran!).

I did NOT want to be bloated, slow, and moody for the hectic end-of-year rigamarole of high school English, so we decided to wait until summer to start stims and do the egg retrieval and embryo transfer. In the meantime, I got an email from some other lady - we'll call her C - saying she's new to the clinic and that she's going to be our IVF coordinator and do I have any questions. Uh, yeah. Who the hell are you? And, no you're not going to by my IVF coordinator. I met B; I trust B; B will be my IVF coordinator. It's not okay to switch on someone in a situation like this. There is just too much at stake.

Ok, so I got that straightened out. B will be my coordinator. Done.

Well, B called me last Monday to say that she would not be in the office on Thursday (the day of my first appt. for suppression scan, catheter measurement, drug order, protocol explanation, etc.) and that she wanted to tell me personally because I had specifically requested to work with B. I was okay with this since she called; plus, it was a one-time thing, and she assured me that she is going to be my coordinator. I was hesitant, but agreed.

Upon my first meeting C, she went over the protocol for our IVF. It is called the lo-dose hCG protocol because I will be injecting a small amount of hCG along with Lupron and Gonal-F every day. This being my first (and hopefully last) IVF, I was confused about the hCG. In the past, I had always taken a very large dose of hCG to induce ovulation, so I wanted to know what function the small amount of hCG has. What does it do? How does it make my body react? Simple question, right? It should be for a professional. C looked at me, baffled, and proceeded to cough out some crap about it being a "helper hormone." I wanted to reassure her that she could speak to me in medical terms and explain to me what exactly it does in my body. So I told her I was just curious about what role it plays in the stimulation. She coughed a little again and spat out the same shit about "helper hormones" and then told me that it was okay that I was just confused.

I'm confused?! No, no. I believe you're confused. I dropped it. She obviously didn't know the answer.

When Kev arrived at the appointment, I told him about the interaction. He was curious as well, and decided that after the scan, he would ask her the same question after giving her sufficient time to find the correct answer (while in my scan). I was amazed that this time she said that she was confused (not him, not me) and again that it was a "helper hormone." Are you freaking kidding me? That's it? You've had fifteen minutes to either ask someone for the answer or look it up in one of the hundreds of medical reference books and databases at your disposal, knowing that you would have to see me again, and you didn't find the answer for me?

I will just say that I am glad C will not be coordinating my IVF. She's a nice enough gal, but I need to trust that my questions can be answered professionally and to my satisfaction. Should I say anything to B this Friday when I go back for my first follie scan?

Wow. These hormone shots must be getting to me. I just realized that I've ranted about this for about an hour. I'm not usually this negative in my writing. Maybe it's a good sign that I'm cooking some strong, healthy eggs!

HERON BY MOONLIGHT

It's been a while since I've posted a pic from "on the road," so here is one from Northwestern Missouri, captured at the lake my family retreats to once a year.

Kev and I went with my mother, my sister, her husband, their daughter's boyfriend, and my great-niece and great-nephew on a moonlight fishing outing on the pontoon. The moon was beautiful, the lake was calm, and the critters were stirring. The little ones had fun pointing out marmots, snakes, and owls, while I was enchanted by this magnificent bird.